Application
The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements |
Prerequisites
Not Applicable
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
1. Address requirements of the state/territory Mental Health Act | 1.1 Explain the concept of mental illness as defined in the Mental Health Act 1.2 Identify and apply the key features of the Mental Health Act 1.3 Apply an understanding of the history, social, political and economic context of mental health in Australia 1.4 Support the rights of the consumer with mental health issues 1.5 Apply an understanding of national and state/ territory mental health policies and strategies 1.6 Work in a manner that reflects an understanding of the underpinning values and philosophies of mental health care and is consistent with legal obligations |
2. Respond appropriately to signs of mental illness | 2.1 Identify conditions relating to the mental state and behaviour of consumers using broad classifications of mental illness and terms commonly associated with mental health issues 2.2 Recognise the signs and symptoms of mental health disorders and respond within the role of an Enrolled/Division 2 nurse 2.3 Recognise biopsychosocial effects of mental health disorders 2.4 Recognise stereotyping and stigma associated with mental illness and practice in a manner which minimises the effects of negative behaviours and discrimination 2.5 Recognise the impact of stigma and discrimination on consumers with mental health issues, and reflect on own attitudes and values 2.6 Apply feedback from consumers and carers in adjusting own practice |
3. Contribute to planning care for consumers with mental health issues | 3.1 Participate as a member of the health care team in the management of consumers with mental health issues within the role of Enrolled/Division 2 nurse 3.2 Gather, record and document data according to health care environment policy 3.3 Participate in multidisciplinary team meetings and liaise with and utilise appropriate resources and service providers, ensuring relevant approaches are used to address individual and group needs 3.4 Observe signs and symptoms of changing behaviours and attend to biopsychosocial needs in performing nursing interventions 3.5 Participate as a member of the health care team to plan the management of consumers with mental health issues within the role of Enrolled/Division 2 nurse 3.6 Apply a community development approach where appropriate within the Enrolled/Division 2 nurse scope of practice to maximise outcomes for individuals and groups 3.7 Under supervision of a registered nurse, undertake client assessments using recognised assessment processes 3.8 Demonstrate understanding of the consumer's right to contribute to their own care planning 3.9 Where appropriate, and where the consumer has given permission, support the participation of carers in treatment planning |
4. Contribute to the care of a consumer with a mental health disorder | 4.1 Implement nursing interventions of a mental health consumer 4.2 Plan, prioritise and implement nursing interventions for a mental health consumer based on the individual care plan in conjunction with multidisciplinary team and with the consumer and, where relevant, the carer 4.3 Reflect the individuality and needs of each consumer when undertaking nursing interventions to assist the consumer to meet their holistic needs 4.4 Document behaviour patterns or characteristics in the client's care plan 4.5 Work in a manner that aims to provide respect and dignity to consumers 4.6 Assist the consumer and significant others to participate in therapeutic nursing interventions 4.7 Perform nursing interventions in accordance with professional, legal and organisation requirements reflecting non-discriminatory practice 4.8 Check consumer understanding of the use and effects of medications used to manage mental health disorders, including specific adverse effects 4.9 Identify and explain to consumer methods of drug administration 4.10 Recognise emergency situations, act upon, document and report according to organisation policy and procedures 4.11 Establish a therapeutic environment within the scope of Enrolled/Division 2 nurse practice 4.12 Provide advice and information to groups and individuals as required to ensure they are fully informed about relevant issues and opportunities within a community development approach |
5. Assist evaluation of outcomes of planned nursing actions | 5.1 Document consumer response to nursing interventions and report to the registered nurse or other appropriate mental health care team member 5.2 Comply with the legal responsibilities and duty of care in all nursing interventions 5.3 Apply ethical and moral concepts to all clinical interventions 5.4 Ensure work practices reflect understanding of the interrelationships of the needs and rights of the individual, the family, the community and society |
6. Provide and maintain a safe working environment | 6.1 Identify triggers of problem behaviours and within the scope of Enrolled/Division 2 nursing practice, initiate prevention strategies 6.2 Implement de-escalation techniques and negotiation skills as required 6.3 Maintain safety of self and others |
Required Skills
This describes the essential skills and knowledge and their level required for this unit. |
Essential knowledge: The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role This includes knowledge of: Activities of daily living Application of nursing theory to a mental health context Basic human, social, psychological, cognitive and physical development Confidentiality and privacy Consumer and carer perspectives on mental health care Cultural factors affecting people with mental health problems Definition and description of common mental disorders Documentation principles Effective communication skills Emergency actions Ethical guidelines including confidentiality, duty of care and public liability Impact of culture and belief systems on mental health and illness Impact of stigma and discrimination on consumers with mental health issues Knowledge of different types of common behaviours associated with mental health problems and their effect on consumer needs Legislation and codes of practice that relate to an Enrolled/Division 2 nurse Mental Health Act - 'Authorised person' Organisation policies and procedures for privacy and confidentiality of information Organisation policies, procedures, guidelines and protocols (i.e. daily living, medication, dealing with changes in wellbeing, sexual harassment, abuse prevention) Organisation policy and procedures Organisation's definition of challenging behaviour related to mental health problems Perspectives of mental health, mental health problems and mental illness Prevention and management of challenging behaviours including recognising triggers and deflecting them, using active listening and observation skills, ensuring effective communication, seeking expert assistance Principles of empowerment/disempowerment for people with mental health problems Principles of non-discriminative practice Principles of psycho-social rehabilitation Relevant anatomy, physiology and associated pathophysiology Relevant legislation related to mental illness Relevant mental health terminology continued ... |
Essential knowledge (contd): Relevant occupational safety policies, procedures and guidelines to ensure safe practice Risk assessment in the mental health context Supervision and reflective practice Therapeutic alliance Understanding of support requirements for people with mental health problems Understanding of the principles of community development as they may apply to clients with mental health issues Understanding of work roles or services provided in specific areas (ie. lifespan approach, people from culturally and linguistically diverse groups, Aboriginal and Torres Strait Islanders, alcohol and other drugs abuse) Understanding the principles of a recovery model in the mental health context |
Essential skills: It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role This includes the ability to: Apply professional standards of practice: ANMC code of conduct ANMC code of ethics ANMC national Enrolled/Division 2 nurse competency standards state/territory Nurse Regulatory Nurses Act state/territory Nursing and Midwifery Regulatory Authority standards of practice scope of nursing practice decision making framework Apply problem solving skills, including an ability to use tools and techniques to solve problems, analyse information and make decisions that require discretion and confidentiality Facilitate activities of daily living Perform nursing interventions such as: assist with electro-convulsant therapy assisting with physical care behavioural observation counselling establishment of therapeutic relationships first aid group or diversional therapy pre and post procedure care prevention and management of aggression skill building programs social normalisation programs social normalisations Undertake observations: ability to communicate aggression - physical or verbal close/constant improvements or deterioration in signs/symptoms level of coherence level of risk levels of personal distress and anxiety orientation to person, place, time signs of physical injury/distress continued ... |
Essential skills (contd): Use interpersonal skills, including working with others, empathising with consumer and relatives, using sensitivity when dealing with people and relating to persons from differing cultural, social and religious backgrounds Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service. Advanced oral communication skills include interviewing techniques, asking questions, active listening, asking for clarification from consumer or other persons where appropriate, negotiating solutions, acknowledging and responding to a range of views. The work may involve using interpreters Use written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service. The level of skill may range from reading and understanding incident reports and case management materials to preparing handover reports for receiving agency staff Work effectively with consumers with mental health illnesses in both general and specialist environments, and with carers, colleagues and other health care providers |
Evidence Required
The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package. | |
Critical aspects for assessment and evidence required to demonstrate this competency unit: | The individual being assessed must provide evidence of specified essential knowledge as well as skills Observation of performance in a work context is essential for assessment of this unit Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse with qualifications in mental health Observation must include: key features of the Mental Health Act Enrolled/Division 2 nurse's role and responsibilities within the mental health environment rights of the client in a mental health environment nursing management of common mental health disorders, specific medications and support strategies within the defined scope of practice documentation assessment of risk |
Context of and specific resources for assessment: | This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible |
Method of assessment | Observation in the work place Written assignments/projects Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice Questioning - verbal and writing Participation in supervision/reflective practice activities Role play/simulation Reflective journal To ensure consistence of performance evidence should be collected over time and include a range of different clinical situations |
Access and equity considerations: | All workers in the health industry should be aware of access and equity issues in relation to their own area of work All workers should develop their ability to work in a culturally diverse environment In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities |
Related units: | This unit is recommended to be assessed in conjunction with the following related units: HLTAP501B Analyse health information HLTEN502B Apply effective communication in complex situations HLTEN509B Apply legal and ethical parameters This competency unit incorporates the content of: HLTEN410B Deliver nursing care to consumers with mental health issues |
Range Statement
The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts. | |
The key features of the Mental Health Act must include: | Objectives Involuntary admission Consumer rights Involuntary review processes Seclusion and restraint Admission procedures Community treatment orders The role of the mental health practitioner Consent Confidentiality Definition of key terms |
Health team may include: | Psychiatrist Psychologist Social worker Welfare officers Nursing team Recreation officers Program officers or activity officers Occupational therapist Health workers Drug and alcohol workers General practitioner Consumer advocate Carer Residential care worker |
Resources and service providers may include: | Government agencies Non-government agencies 24 hour crisis services Community mental health centres Rehabilitation services Family/carer support services Consumer services Outreach services Psychiatric disability services School counsellors Acute Inpatient |
Working with individuals and groups to achieve community development outcomes may include: | Engagement with various structures and patterns of work undertaken by practitioners and community members including: Community service delivery Community projects Community development Community action Community planning Consultative and planning committees Sector development structures |
Broad classifications of mental illness must include: | Mood disorders Personality disorders Anxiety disorders Psychoses Organic disorders Mental health |
Common terms associated with mental health may include: | Psychology/psychiatry Consumer Reality testing Risk assessment Psychosis Anorexia nervosa/Bulimia nervosa Functional disorders/Organic disorders Restraint/Seclusion Advocacy Recovery Therapeutic relationship Sexual safety Dual diagnosis |
Common terms associated with anxiety disorders, personality disorders, psychotic disorders and mood disorders may include: | Antisocial/Avoidant Bipolar disorder Borderline Challenging behaviours Dependent/Depressive Drug induced psychosis Dysthymic disorder Eating disorders Fear Generalized anxiety disorder Hallucinations Histrionic/Narcissistic Major depressive disorder Major depressive episode Manic episode/Hypomanic episode Obsessive -compulsive/Paranoid Obsessive-compulsive disorder Panic disorder Passive-aggressive Post traumatic stress disorder Schizophrenia Social Phobia and specific phobias Substance abuse Suicide ideation |
Common diagnoses must include: | Panic disorder Social phobia and specific phobias Obsessive-compulsive disorder Post traumatic stress disorder Depression Bipolar disorder Eating disorder Borderline personality disorder Schizophremia Dementia Delirium Anxiety disorder |
Consumer mental health needs may include: | Psychoeducation Emotional support Social support Financial advice Food and clothing Transport Carer support Drug and alcohol counselling Respite care Emergency relief Legal advice Accommodation support Referral to other agencies |
Appropriate communication and relationship building processes may include: | Engagement Empathy Non judgemental manner Active listening Acknowledging the person in a pleasant and accepting manner Treating the person as an individual with their own life history, skills and interests Rapport building Warmth Genuineness Respect Limit setting where appropriate Identifying strengths Including consumer and family |
Response to consumers in distress and crisis will include: | Identifying and considering specific risk Enlisting support and/or assistance from colleagues or emergency support as appropriate Applying organisation policies and procedures Using calm and calming behaviour Reporting incidents promptly and accurately |
Support processes may be informal and/or formal and may include: | Problem solving techniques Evaluation Risk assessment Interviewing techniques Information provision Group work Individual support Working with carers and others Relaxation management Stress management Anger management Coping strategies Counselling and support groups |
Nursing observations of the mental health consumer may include: | Appearance/behaviour Speech Sleep Appetite Emotional reactions/mood/ cognition Form of thought/ perception/insight Disturbance in language Risk assessment |
Consumer characteristics or behaviour patterns that require documentation may include: | Suicidal ideation Mania Hostile, combative behaviours Delusions, hallucinations Confusion Withdrawn behaviour Depression Aggression Manipulative behaviour Sexually inappropriate behaviour |
Ethical concepts may include: | Integrity Confidentiality Advocacy Accountability Respect Safety Non-judgmental attitudes Treatment choices |
The classification of medications used in mental health treatments may include: | Mood stabilizers Antidepressants Anti anxiety agents Antipsychotic / neuroleptic drugs Sedatives/hypnotics |
Specific adverse effects may include: | Dystonia Akathisia Parkinsonian syndrome Tardive dyskinesia Neuroleptic malignant syndrome Orthostatic hypotension Photosensitivity Toxicity Hypertension / hypotension Weight gain |
Activities to promote consumer dignity may include: | Communicate with consumer - inform, explain Confidentiality, privacy and respect Facilitate choice where reasonable Provide consistency and consideration Attention to hygiene, grooming and positive self image Provide encouragement Safety and security Inclusion in formal decision-making processes where possible |
Therapeutic environment may include: | Non judgmental Safe Consistent Consumer focussed Promotion of independence |
Types of therapies may include: | Counselling Group Therapy Pharmacological Electroconvulsive therapy Psychotherapy Cognitive behavioural therapy |
Sectors
Not Applicable
Employability Skills
This unit contains Employability Skills |
Licensing Information
Not Applicable